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The nature
of stigma and discrimination
The
"undesirable differences" and "spoiled identities" that
HIV/AIDS-related stigma causes do not naturally exist, they
are created by individuals and by communities. Stigmatization
describes this process of devaluation.
HIV/AIDS-related stigma builds upon, and reinforces, existing
prejudices. It also plays into, and strengthens, existing
social inequalities - especially those of gender, sexuality
and race.
HIV/AIDS-related stigma and discrimination play a key role in
producing and reproducing relations of power and control. They
cause some groups to be devalued and others to feel that they
are superior. Ultimately, stigma creates and is reinforced by
social inequality.
Stigma,
discrimination and human rights
Prejudiced and stigmatizing thoughts frequently lead people to
do (or not do) something that denies services or entitlements
to another person. For example, they may prevent health
services being used by a person living with HIV/AIDS, or
terminate their employment on the grounds of their HIV status.
This is discrimination.
Discrimination occurs when a distinction is made against a
person that results in their being treated unfairly and
unjustly on the basis of their belonging, or being perceived
to belong, to a particular group.
Due to
stigma and HIV/AIDS-related discrimination, the rights of
people living with HIV/AIDS and their families are frequently
violated simply because they are known, or presumed, to have
HIV/AIDS. This violation of rights hinders the response and
increases the negative impact of the epidemic.
Freedom
from discrimination is a fundamental human right founded on
principles of natural justice that are universal and
perpetual. The basic characteristics of human rights are that
they inhere in individuals because they are human, and that
they apply to people everywhere.
The
Principle of Non-discrimination is central to human rights
thinking and practice. All international human rights
instruments and the African Charter
prohibit discrimination based race, colour, sex, language,
religion, political or other opinion, national, ethnic or
social origin, property, disability, fortune, birth or other
status.
Recent
UN Commission on Human Rights resolutions,
have unequivocally stated that "the term 'or other status' in
non-discrimination provisions in international human rights
texts should be interpreted to cover health status, including
HIV/AIDS", and has confirmed that "discrimination on the basis
of HIV/AIDS status, actual or presumed, is prohibited by
existing human rights standards".
Discrimination against people living with HIV/AIDS, or those
thought to be infected, is therefore a clear violation of
their human rights.
The
forms of stigma and discrimination faced by people with
HIV/AIDS are multiple and complex. Individuals tend to not
only be stigmatized and discriminated against because of their
HIV status, but also because of what this connotes. Recent
UNAIDS-sponsored research in India and Uganda shows that women
with HIV/AIDS may be doubly stigmatized both as 'women' and
as 'people living with HIV/AIDS' when their seropositivity
becomes known.
States
have obligations to respect protect and fulfil human rights.
In relation to stigma and discrimination, for example, the
obligation to respect requires States not to directly or
indirectly discriminate in law, policy or practice. The
obligation to protect requires States to take measures that
prevent third parties from discriminating,
and the obligation to fulfil requires States to adopt
appropriate legislative, budgetary, judicial, promotional and
other measures to ensure that strategies, policies and
programmes are developed that address the discrimination, and
ensure that compensation is paid to those who suffer
discrimination.
Action to address stigma and discrimination
The
human rights framework provides access to existing procedural,
institutional and other monitoring mechanisms for enforcing
the rights of people living with HIV and AIDS, and for
countering and redressing discriminatory action.
Appropriate reporting and enforcement mechanisms (ranging from
legal aid services to hotlines for reporting acts of
discrimination and violence) have provided powerful and rapid
means of mitigating the worst affects of HIV/AIDS-related
stigmatization and discrimination.
Experience has shown that two complementary kinds of
alleviation strategies are necessary to address stigma and
discrimination: (i) strategies that prevent stigma or
prejudicial thoughts being formed and (ii) strategies that
address or redress the situation when stigma persists and is
acted upon through discriminatory action, leading to negative
consequences or the denial of entitlements or services.
Ultimately, it is at the community and national levels that
HIV/AIDS-related stigma and discrimination are most
effectively combated. Communities and community leaders must
advocate for inclusiveness and equality irrespective of HIV
status.
1
The right to non-discrimination is enshrined in Article 2 of
the Universal Declaration on Human Rights; International
Covenant on Civil and Political Rights; International Covenant
on Economic Social and Cultural Rights; Convention on
Elimination of All Forms of Discrimination Against Women;
Convention on the Rights on the Child; the African Charter.
2
Commission on Human Rights, Resolutions 1999/49 and 2001/51.
4
For example, adopting of legislation to ensure the equal
access to health care and health related services provided by
third parties; to control the marketing of medicines and
medical equipment and to ensure that medical practitioners and
other health professionals meet appropriate standards of
education, skill and ethical codes of conduct.
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